Nature of facial injuries can reveal domestic violence

Philadelphia, United States, January 20: According to researchers, the nature of facial injuries may be very helpful in identifying women who are the victims of domestic violence.

The study, published in the Archives of Facial Plastic Surgery’s January/ February issue, reports that facial injuries to a battered person by an intimate partner, were most likely to be periorbital fractures or intracranial injuries. The research was carried out by Oneida A. Arosarena, MD, Temple University, and his colleagues.

According to Dr. Arosarena’s group, fractures of the jawbone, caused due to assault by an unknown striker, combined with deferred presentation after the injury, multiple injuries in various stages of healing or discrepancies in the stated reasons should hint queries.

The researchers said that facial plastic surgeons and other providers engaged in the treatment of maxillofacial injuries are in “a unique position” to recognize victims of such violence and kick off apt medical and social intervention in tune with the victim’s requirements.

One of the findings of the study shows that 34 to 73 percent of facial injuries in women are a result of violence by an intimate partner. Head and neck injuries are commonly met with in such assaults, 88 to 94.4 percent to be precise.

To aid physicians in differentiating these cases from other instances of trauma, the researchers reassessed medical and dental records of 326 adult female facial trauma patients, who were doctored by either otolaryngologists or maxillofacial surgeons at a medical center in Kentucky.

Assault occupied the third place as a cause of facial trauma (13.8 percent), preceded by vehicle crashes (42.6 percent) and falls (21.5 percent) in the first and second place respectively. Among these 13.8 percent assault victims, 42.2 percent were victims of domestic violence, while the rest of them could not recognize their attacker. As expected, only 15.6 percent assault cases were reported to the police or social workers.

The differences in the nature of injury among victims of domestic violence in contrast with the overall incidence among women, as highlighted by the study are:
- Three times increase in occurrence of orbital blowout fracture (9 percent versus about 3 percent).

- Higher instances of mandible fracture (4 percent versus 2 percent).

- Higher recurrence of zygomatic complex fracture (4 percent versus 3 percent).

- Decrease in rates of nasal fracture (6 percent versus more than 8 percent).

- Higher susceptibility to intracranial injury (more than 2 percent versus less than 1 percent).

The researchers said, “Recognition of fracture patterns, as well as patient’s manners of presentation can assist physicians in identifying intimate partner violence and can be effective in the development of protocols and programs aimed at comprehensive treatment and follow-up with these patients.” But early detection and intervention is the key, said Dr. Arosarena’s group.